Healthcare Provider Details

I. General information

NPI: 1649733692
Provider Name (Legal Business Name): CHRISTOPHER JULIAN GAUSE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2019
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8423 MARKET ST STE 207
BOARDMAN OH
44512-6778
US

IV. Provider business mailing address

8423 MARKET ST STE 207
BOARDMAN OH
44512-6778
US

V. Phone/Fax

Practice location:
  • Phone: 330-965-5490
  • Fax: 330-965-5491
Mailing address:
  • Phone: 330-965-5490
  • Fax: 330-965-5491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number34.017801
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number34.017801
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: